Question 1

A 35-year-old woman is at the clinic for a gynecologic examination.During the examination,she asks the nurse,"How often do I need to have this Pap test done?" Which reply by the nurse is correct?

Accepted Answer

A)   "It depends. Do you smoke?"
B)   "This will need to be done annually until you are 65."
C)   "If you have 2 consecutive normal Pap tests, then you can wait 5 years between tests."
D)   "After age 30, if you have 3 consecutive normal Pap tests, then you may be screened every 2 to 3 years." D

Question 2

Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview?

Accepted Answer

A)   "Now it is time to talk about your sexual history. When did you first have intercourse?"
B)   "Women often feel dissatisfied with their sexual relationships. Would it be okay to discuss this now?"
C)   "Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?"
D)   "Most women your age have had more than one sexual partner. How many would you say you have had?" C

Question 3

The nurse is preparing to examine the external genitalia of a school-age girl.Which of these positions would be most appropriate in this situation?

Accepted Answer

A)   In the parent's lap
B)   In a frog-leg position on the examining table
C)   In the lithotomy position with the feet in stirrups
D)   Lying flat on the examining table with legs extended B

Question 4

A woman who is 22 weeks pregnant has a vaginal infection.She tells the nurse that she is afraid that this infection will hurt the fetus.The nurse knows that which of these statements is true?

Accepted Answer

A)   If intercourse is avoided, then the risk for infection is minimal.
B)   A thick mucus plug forms that protects the fetus from infection.
C)   The acidic pH of vaginal secretions promotes the growth of pathogenic bacteria.
D)   The mucus plug that forms in the cervical canal is a good medium for bacterial growth.

Question 5

An 11-year-old girl is in the clinic for a sports physical.The nurse notices that she has begun to develop breasts,and during the conversation the girl reveals that she is worried about her development.The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should:

Accepted Answer

A)   use the Tanner's table on the five stages of sexual development.
B)   describe her development and compare it with that of other girls her age.
C)   use Jacobsen's table on expected development on the basis of height and weight data.
D)   reassure her that her development is within normal limits and should tell her not to worry about the next step.

Question 6

A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic.As a part of the interview,the nurse should ask,"Have you noticed:

Accepted Answer

A)   a change in your urination patterns?"
B)   any excessive vaginal bleeding?"
C)   any unusual vaginal discharge or itching?"
D)   any changes in your desire for intercourse?"

Question 7

A 52-year-old patient states that when she sneezes or coughs she "wets herself a little." She is very concerned that something may be wrong with her.The nurse suspects that the problem is:

Accepted Answer

A)   dysuria.
B)   stress incontinence.
C)   hematuria.
D)   urge incontinence.

Question 8

A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination.Which of these statements should the nurse include in patient education? "A postmenopausal woman:

Accepted Answer

A)   is not at any greater risk for heart disease than a younger woman is."
B)   should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions."
C)   has only stopped menstruating; there really are no other significant changes with which she should be concerned."
D)   is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle."

Question 9

During the interview a patient reveals that she has some vaginal discharge.She is worried that it may be a sexually transmitted infection.The nurse's most appropriate response to this would be:

Accepted Answer

A)   "Oh, don't worry. Some cyclic vaginal discharge is normal."
B)   "Have you been engaging in unprotected sexual intercourse?"
C)   "I'd like some information about the discharge. What color is it?"
D)   "Have you had any urinary incontinence associated with the discharge?"

Question 10

The nurse is reviewing the changes that occur with menopause.Which of these are changes associated with menopause?

Accepted Answer

A)   Uterine and ovarian atrophy along with thinning vaginal epithelium
B)   Ovarian atrophy, increased vaginal secretions, and increasing clitoral size
C)   Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions
D)   Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy

Question 11

When the nurse is discussing sexuality and sexual issues with adolescents,a permission statement helps to convey that it is normal to think or feel a certain way.Which of these is the best example of a permission statement?

Accepted Answer

A)   "It is okay that you have become sexually active."
B)   "Often girls your age have questions about sexual activity. Have you any questions?"
C)   "If it is okay with you, I'd like to ask you some questions about your sexual history."
D)   "Often girls your age engage in sexual activity. It is okay to tell me if you have had intercourse."

Question 12

A 22-year-old woman is being seen at the clinic for problems with vulvar pain,dysuria,and fever.On physical examination,the nurse notices clusters of small,shallow vesicles with surrounding erythema on the labia.There is also inguinal lymphadenopathy present.The most likely cause of these lesions is:

Accepted Answer

A)   pediculosis pubis.
B)   contact dermatitis.
C)   human papillomavirus.
D)   herpes simplex virus type 2.

Question 13

A woman has just been diagnosed with HPV,or genital warts.The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for _____ cancer.

Accepted Answer

A)   uterine
B)   cervical
C)   ovarian
D)   endometrial

Question 14

The nurse has just completed an inspection of a nulliparous woman's external genitalia.Which of these would be a description of a finding within normal limits?

Accepted Answer

A)   Redness of the labia majora
B)   Multiple nontender sebaceous cysts
C)   Discharge that is sticky and yellow-green
D)   Gaping and slightly shriveled labia majora

Question 15

The nurse is preparing to interview a postmenopausal woman.Which of these statements is true with regard to the history of a postmenopausal woman?

Accepted Answer

A)   The nurse should ask a postmenopausal woman if she ever has vaginal bleeding.
B)   Once a woman reaches menopause, the nurse does not need to ask any further history questions.
C)   The nurse should screen for monthly breast tenderness.
D)   Postmenopausal women are not at risk for contracting sexually transmitted infections and thus these questions can be omitted.

Question 16

When performing an external genitalia examination of a 10-year-old girl,the nurse notices that there is no pubic hair,and the mons and the labia are covered with fine vellus hair.These findings are consistent with stage _____ of sexual maturity,according to the Sexual Maturity Rating scale.

Accepted Answer

A)   1
B)   2
C)   3
D)   4

Question 17

During an examination the nurse observes a female patient's vestibule and expects to see the:

Accepted Answer

A)   urethral meatus and vaginal orifice.
B)   vaginal orifice and vestibular (Bartholin)  glands.
C)   urethral meatus and paraurethral (Skene)  glands.
D)   paraurethral (Skene)  and vestibular (Bartholin)  glands.

Question 18

A woman who is 8 weeks pregnant is in the clinic for a checkup.The nurse reads on her chart that her cervix is softened and looks cyanotic.The nurse knows that the woman is exhibiting _____ sign and _____ sign.

Accepted Answer

A)   Tanner's; Hegar's
B)   Hegar's; Goodell's
C)   Chadwick's; Hegar's
D)   Goodell's; Chadwick's

Question 19

A 22-year-old woman has been considering using oral contraceptives.As a part of her history,the nurse should ask:

Accepted Answer

A)   "Do you have a history of heart murmurs?"
B)   "Will you be in a monogamous relationship?"
C)   "Have you thought this choice through carefully?"
D)   "If you smoke, how many cigarettes do you smoke per day?"

Question 20

During a health history,a 22-year old woman asks,"Can I get that vaccine for HPV? I have genital warts and I'd like them to go away!" What is the nurse's best response?

Accepted Answer

A)   "The HPV vaccine is for girls and women ages 9 to 26, so we can start that today."
B)   "This vaccine is only for girls who have not started to have intercourse yet."
C)   "Let's check with the physician to see if you are a candidate for this vaccine."
D)   "The vaccine cannot protect you if you already have an HPV infection."

Exam 26: Female Genitourinary System